Ramanathan Kollengode, Mohammed Hend, Hopkins Peter, Corley Amanda, Caruana Lawrence, Dunster Kimble, Barnett Adrian G, Fraser John F
The Critical Care Research Group, The Prince Charles Hospital and the University of Queensland, Brisbane, QLD 4032, Australia.
The Critical Care Research Group, The Prince Charles Hospital and the University of Queensland, Brisbane, QLD 4032, Australia; Queensland Centre for Pulmonary Transplant and Vascular Disease, The Prince Charles Hospital and the University of Queensland, Brisbane, QLD 4032, Australia.
Can Respir J. 2016;2016:2471207. doi: 10.1155/2016/2471207. Epub 2016 Jun 30.
Background. Lung transplantation is the optimal treatment for end stage lung disease. Donor shortage necessitates single-lung transplants (SLT), yet minimal data exists regarding regional ventilation in diseased versus transplanted lung measured by Electrical Impedance Tomography (EIT). Method. We aimed to determine regional ventilation in six SLT outpatients using EIT. We assessed end expiratory volume and tidal volumes. End expiratory lung impedance (EELI) and Global Tidal Variation of Impedance were assessed in supine, right lateral, left lateral, sitting, and standing positions in transplanted and diseased lungs. A mixed model with random intercept per subject was used for statistical analysis. Results. EELI was significantly altered between diseased and transplanted lungs whilst lying on right and left side. One patient demonstrated pendelluft between lungs and was therefore excluded for further comparison of tidal variation. Tidal variation was significantly higher in the transplanted lung for the remaining five patients in all positions, except when lying on the right side. Conclusion. Ventilation to transplanted lung is better than diseased lung, especially in lateral positions. Positioning in patients with active unilateral lung pathologies will be implicated. This is the first study demonstrating changes in regional ventilation, associated with changes of position between transplanted and diseased lung.
背景。肺移植是终末期肺病的最佳治疗方法。供体短缺使得单肺移植（SLT）成为必要，但关于通过电阻抗断层扫描（EIT）测量的患病肺与移植肺的区域通气情况的数据极少。方法。我们旨在使用EIT确定6名单肺移植门诊患者的区域通气情况。我们评估了呼气末容积和潮气量。在移植肺和患病肺的仰卧位、右侧卧位、左侧卧位、坐位和站立位评估呼气末肺阻抗（EELI）和阻抗的整体潮气量变化。采用具有每个受试者随机截距的混合模型进行统计分析。结果。在右侧卧位和左侧卧位时，患病肺和移植肺之间的EELI有显著变化。一名患者出现了肺间摆动气，因此被排除以进一步比较潮气量变化。除右侧卧位外，其余5名患者在所有体位下移植肺的潮气量变化均显著更高。结论。移植肺的通气优于患病肺，尤其是在侧卧位时。这将对患有活动性单侧肺部病变的患者的体位摆放产生影响。这是第一项证明区域通气变化与移植肺和患病肺之间体位变化相关的研究。
